Insurance

Insurance FAQs

Kaplan Sinus Relief accepts most major insurance plans, including Medicare, Aetna, Blue Cross Blue Shield, Cigna, and UnitedHealthcare for ENT visits, allergy evaluations, balloon sinuplasty, and other sinus procedures performed in our Houston office.

How It Works

We accept most major insurance plans

If you’re dealing with sinus pressure, congestion, allergy symptoms, or a condition that hasn’t responded to medication, cost and coverage shouldn’t be what’s standing in your way. Kaplan Sinus Relief participates in a wide range of commercial, Medicare, and Medicare Advantage insurance plans so that more patients can access the care they need.

Whether you’re coming in for an ENT evaluation, allergy testing, balloon sinuplasty, or a follow-up visit, our team will verify your benefits before your appointment and walk you through what your plan covers.

Insurance Provider	Type of Insurance
A
AARP	Medicare Advantage: PPO, HMO, POS, Indemnity, Other
Aetna	Commercial: PPO, HMO, EPO, POS
	Medicare Advantage: PPO, HMO, HMO-POS, Out-of-State
All Savers Insurance	ACA Marketplace (Commercial Exchange): PPO, POS
Allied	Allied Benefit System #1
	Allied Benefits Systems #2
Allstate	Allstate
Anthem Blue Cross	Commercial: PPO
Anthem Blue Cross Blue Shield	Commercial: PPO, POS
	ACA Marketplace (Commercial Exchange): PPO, POS
	Medicare Advantage: PPO, Out-of-State
	Federal: HMO
APWU	Commercial: Indemnity
Arkansas Blue Cross Blue Shield	Commercial: PPO, Out-of-State
	Medicare Advantage: PPO
Assurant Health	Commercial: PPO
B
Banker's Life	Medicare Advantage: Other
Benefit Health Plan	Benefit Health Plan Inc
Blackhawk Claims Services	Blackhawk Claims Services GA
Blue Cross Blue Shield	Commercial: PPO, HMO
	Medicare Advantage: PPO
	WELLPOINT
Blue Cross Blue Shield Federal Employee Program	Commercial: PPO, EPO
Blue Cross Blue Shield of Alabama	Commercial: PPO
	90 Degree Benefits
Blue Cross Blue Shield of Arizona	Commercial: PPO
Blue Cross Blue Shield of Georgia	Commercial: PPO, POS
Blue Cross Blue Shield of Illinois	Commercial: PPO, POS
Blue Cross Blue Shield of Kansas	Commercial: PPO
	ACA Marketplace (Commercial Exchange): PPO
Blue Cross Blue Shield of Kansas City	Commercial: PPO
Blue Cross Blue Shield of Louisiana	Commercial: PPO
Blue Cross Blue Shield of Massachusetts	Commercial: PPO
Blue Cross Blue Shield of Michigan	Commercial: PPO
Blue Cross Blue Shield of Minnesota	Commercial: PPO, POS
	ACA Marketplace (Commercial Exchange): PPO
Blue Cross Blue Shield of Mississippi	Commercial: PPO
Blue Cross Blue Shield of Montana	ACA Marketplace (Commercial Exchange): PPO
Blue Cross Blue Shield of Nebraska	Commercial: PPO
Blue Cross Blue Shield of New Mexico	Commercial: PPO
	ACA Marketplace (Commercial Exchange): PPO
Blue Cross Blue Shield of North Carolina	Commercial: PPO, POS
	Medicare Advantage: PPO
Blue Cross Blue Shield of North Dakota	Commercial: PPO
Blue Cross Blue Shield of Oklahoma	Commercial: PPO
	ACA Marketplace (Commercial Exchange): PPO
Blue Cross Blue Shield of Rhode Island	Commercial: PPO
	ACA Marketplace (Commercial Exchange): PPO
Blue Cross Blue Shield of South Carolina	Commercial: PPO
	Medicare Advantage: PPO
Blue Cross Blue Shield of Tennessee	Commercial: PPO
Blue Cross Blue Shield of Texas	Commercial: PPO, HMO, EPO, POS, Indemnity
	ACA Marketplace (Commercial Exchange): PPO, HMO
	Medicare Advantage: PPO, HMO
Blue Cross Blue Shield of Vermont	Commercial: PPO
Blue Cross Blue Shield of Wyoming	Commercial: PPO
Blue Cross of Idaho	Commercial: PPO
Blue Cross of Northeastern Pennsylvania	Commercial: PPO
Blue Shield of California	Commercial: PPO
	Federal: Out-of-State
Blue Shield of Northeastern New York	Commercial: PPO
Boon Chapman Benefit Admin Inc.	Boon Chapman Benefit Admin
C
Centene Corporation	Wellcare Health Plans
Cigna	Commercial: PPO, HMO, POS
	Medicare Advantage: PPO, HMO, Out-of-State
	Allegiance
	Cigna Medicare Supplement
Cigna-HealthSpring	Medicare Advantage: PPO, HMO, Other, Out-of-State
Community Health Choice	Commercial: HMO
	ACA Marketplace (Commercial Exchange): HMO
	Community Health Choice Plan
Curative	Curative
D
Devoted Health	Devoted Health
E
EmblemHealth (formerly known as GHI)	Commercial: PPO
EMI HEALTH	EMI HEALTH
Entrust	Entrust
F
First Choice Health	Commercial: PPO
First Health (Coventry Health Care)	Commercial: PPO
Frontier Health	Frontier Health
G
GEHA	Commercial: PPO
Gravie Administrative Services	Gravie Administrative Services
Guardian	Commercial: PPO
GuideWell	WEB-TPA, Inc
GWH-Cigna (formerly Great West Healthcare)	Commercial: PPO
H
HealthEZ	HealthEZ
HealthSmart	Commercial: PPO
	Preferred Care Inc.
Health Plans, Inc.	Employer Health Network
	Health Plans Inc
Humana	Commercial: PPO, POS
I
Imagine360	Imagine360
Inova Care Partners	MBR-InovaCare
IntegraNet Health	IntegraNet Health
	Integranet Health Claim Dept
J
No Results
K
No Results
L
Luminare Health	Luminare Health
M
M3TPA	M3TPA
Mail Handlers Benefit Plan	Commercial: PPO, POS
Medicare	Medicare
	Medicare Advantage: PPO, HMO, Indemnity, Other
Medi-Share	Medi-Share
Memorial Hermann	Commercial: PPO
Meritain Health	Commercial: PPO, POS
Multiplan PHCS	Commercial: PPO
Mutual of Omaha	Medicare Advantage: HMO, Other
N
New Era Life	Philadelphia American Life
No Primary Insurance Company	No Primary Insurance Company
O
Optum	WellMed Claims
Ovation HealthCare	Ovation Health
P
Principal Financial Group	Commercial: PPO
Q
No Results
R
Railroad Medicare	Railroad Medicare
S
Sana Benefits	Sana Benefits
Staff Benefits Management & Administrators	SBMA
T
TRICARE	US Family Health Plan
U
UniCare	Commercial: PPO
UnitedHealthcare	Commercial: PPO, HMO, EPO, POS
	Medicare Advantage: PPO, HMO, HMO-POS, Out-of-State
	Federal: PPO
	Golden Rule Company
	SUREST/Bind Benefits Inc
	United Medical Resources (UMR)
	UnitedHealthcare One
	UnitedHealthcare Services, Inc.
	UnitedHealthcare Shared Services
	UnitedHealthcare Student Resources
UnitedHealthcare Oxford	Commercial: PPO, EPO
USHEALTH Group, Inc.	Freedom Life Insurance of America
V
Van Lang IPA	Van Lang IPA
W
Wisconsin Rapids Provider Choice	Wisconsin Rapids Provider Choice
X, Y, Z
No Results

Note: Kaplan Sinus Relief verifies your insurance benefits before your visit. Because every plan carries different deductibles, copays, and out-of-pocket maximums, we can't predict your exact costs in advance — but our team will help you understand what to expect based on your specific coverage before you come in. If you don’t see your insurance listed, please call the office at (713) 766-1818.

FAQ

What insurance plans does Kaplan Sinus Relief accept?

Above is our current list of accepted insurance plans. If you don’t see your plan listed, contact our office. We may still be able to see you.

Does Medicare cover ENT visits and balloon sinuplasty?

Yes. Kaplan Sinus Relief accepts Medicare and several Medicare Advantage plans. For patients with Medicare Part B, balloon sinuplasty is generally covered when chronic sinusitis has been diagnosed and other treatments, such as medication or nasal sprays, haven’t provided lasting relief.

Medicare typically covers 80% of the approved cost for medically necessary procedures, with the remaining 20% being the patient’s responsibility. If you carry a Medicare Supplement (Medigap) plan, some or all of that remaining balance may be covered.

For a more detailed breakdown of how Medicare coverage applies to balloon sinuplasty specifically, visit our blog: Does Medicare cover balloon sinuplasty?

What does Medicare NOT cover?

Medicare covers most medically necessary ENT services at Kaplan Sinus Relief, but there are some important limits to understand before your visit.
Medicare generally does not cover:

Hearing aids
Cosmetic or elective procedures

It’s also worth noting that Medicare covers 80% of approved costs after your Part B deductible is met. The remaining 20% is your responsibility unless you carry a Medicare Supplement (Medigap) plan. Our team will walk you through what your plan covers before your appointment.

What if I don't have insurance?

Patients without insurance are welcome at Kaplan Sinus Relief. Our team will provide a clear cost estimate before your visit so you can make an informed decision about your care. Many uninsured patients are surprised to find that an in-office procedure like balloon sinuplasty — when compared to years of recurring prescription costs, urgent care visits, and lost productivity — can be a worthwhile investment in their long-term health.

We encourage you to call our office to discuss your situation and explore your options. Our goal is to help you find a path to relief that works for you.

What is the real cost of living with ENT symptoms?

Many patients who come to Kaplan Sinus Relief have already spent years managing their symptoms with prescription medications, antibiotics, nasal sprays, and repeated doctor visits. When you add up those recurring costs (plus the time missed from work, disrupted sleep, and reduced quality of life), the picture often looks different than it does at first glance.

An ENT evaluation at Kaplan Sinus Relief costs whatever a standard specialist visit runs under your insurance plan. For many patients, it’s covered in full or subject to a standard specialist copay. From there, Dr. Kaplan will assess whether your symptoms can be managed with ongoing care or whether a one-time procedure like balloon sinuplasty might be a better long-term investment.

Most commercial plans and Medicare cover the procedure when it’s deemed medically necessary — meaning many patients’ out-of-pocket costs are significantly lower. Compared to years of medication costs and recurring urgent care or primary care visits, a single in-office procedure often pays for itself.

Want to understand balloon sinuplasty costs in more detail? Read: How much does balloon sinuplasty cost?